Several kinds of methods have been known for the treatment of injuries of the epithelium, such as burns. The accompanying symptoms of injuries depend on the seriousness of the injury and include hyperaesthesia, pain, rubedo, edema; in more serious cases bulla formation results and in the most serious cases the damage of subcutaneous tissues, plasma flow and increased edema are noted.
The first stage of treatment of injuries optionally includes cooling of the skin surface, removal of shock, assuaging of pain, sanitizing of the wound (removal of the unnecessary pieces of epithelium, cutting of bullas, washing) and prophylaxis against infection.
The so-called "air-dressing" as one of the well-known procedures of wound treatment can only be used in a special environment which is low in germs (oxygen tent). For this reason the closed, bandaging treatment is widely popular.
There are transitory forms of treatment between the air-dressing and closed treatment as e.g. the so called "tannic" treatment which reduces exudation and has a pain assuaging effect; this treatment also binds the pathological decomposition products of protein (tannin).
A special variety of the open treatment is the use of film binding gels. A clear, impermeable layer is formed on the surface of the wound by the film binding gels and the following plasma.
The applied gels are based on plastics, e.g. (polyvinyl derivatives, such as vulnoplastin, aeroplast). They are not advisable for serious burns of third degree because of anaerobic dangers.
Preferred medicines of wound treatment are the aerosol packed liquids, powders, ointments. Besides the above mentioned disinfecting washes a 2% mercurochrome solution can successfully be applied alone or together with silver nitrate and tannin.
The air-dressing of wounds in case of deep burns is a disadvantage from the point of view that the spontaneous demarcation of the wound is delayed and so surgical intervention is delayed as well.
In curing serious burns good results were achieved by using lyophilized pig skin as a biological bandage or by the application of synthetic skin covering compositions (e.g. epigard).
During closed treatment the wound is protected from secondary infections by a sterile bandage.
Wounds are treated after a sanitizing treatment by application of a chemotherapeutical, antibiotical agent or an ointment.
The bandage can be a simple dry one. Instead of mull material a nylon thread tulle woven binding material is often used. Bandages impregnated with some other kind of material are often used as well. The most important view-point in choosing these materials is that the bandage should not stick into the wound (paraffin, bee's wax etc.). A special form of hydrotherapeutics allows the bandage to be washed from the wound in different baths.
(Artz, C. P., Reiss, E., Saunders W. B.: Treatment of Burns, Company (1957); Janos, Gy., Novak, J.: Egesi serulesek (Burns), Bpl (1967); Jakab, Lencz, Forgacs: Intenziv betegellatas (intensiv medical attendance), Budapest (1975); Lynch, J. B., Lewis, S. R.: Symposium on the treatment of burns, Saint Louis (1973); and J. of Traum 13, 374-383 (1979).
The disadvantage of bandage treatments is that the covering of a wound is often accompanied by pain, that when the bandage is to be removed it may stick to the wound, and that the binding does not close perfectly which involves the danger of infection. In case of tightly closing wound covers the problem of air access and continuous exudation of discharge is not solved.